Non-surgical palliation of malignant oesophageal obstruction in the elderly

Fourteen elderly patients with malignant oesophageal obstruction have undergone palliative intubation with a modified Celestin tube inserted under intravenous sedation using a fibreoptic endoscopic technique. Eleven patients surviving the two-week post-insertion period had a mean survival time of five months (range 1--20 months). In the majority, palliation was excellent, most patients being able to eat a virtually normal diet within 36 hours of the procedure. This technique has a much lower mortality and morbidity in the elderly than palliative surgery and allows for early mobilization and discharge. Earlier referral of suitable patients is necessary and the technique deserves wider application.